Lake County is geographically situated in a basin, and smoke does not dissipate quickly. Smoke was especially bad in our neighborhood, possibly because the surrounding hills trapped the air. Neighboring homes were visible only through a smoky veil months after the fire storm.
Inhalation of polluted air can result in a toxic injury to the airways, which may cause changes in some people similar to asthma (technically, fibrosis and T-cell activation) and can be experienced as coughing, bloody cough, shortness of breath, reduced lung capacity or related symptoms.
If reaction to airborne toxins is immediate or exposure is severe, the ensuing condition is called Reactive Airways Dysfunction Syndrome (RADS); if exposure is spread out over time or is a lower level of toxin, the reaction is called irritant induced asthma (IIA). The medical establishment does not uniformly recognize the second definition, so chronic or low-level exposure is often called “low-dose RADS.”
Both diagnoses agree, however, that symptoms appear fairly quickly upon exposure (usually within one to 10 days), so if someone has symptoms appearing weeks after exposure has ended, RADS is likely not the cause of lung distress. Both RADS and low-dose RADS are similar to “occupational asthma,” like the condition suffered by firefighters or clean-up workers in a chemical spill. And instances are on the rise.
Many people will recover completely, some may take as long as six months to two years to become free of symptoms, and some may develop a persistent asthma-like condition. Many will remain vulnerable to further toxic exposure like smoke or chemicals.
A summary prognosis of RADS is given by Environmental Health Perspectives (EHPonline.org):
Patients that seek timely medical help often have excellent recovery. Some patients do experience ongoing night-time symptoms, and may intermittently develop acute symptoms for some time. Some patients that are prescribed corticosteroids may develop steroid dependency.
Understanding of RADS could save time and money in diagnosing sufferers. Often, this irritation does not show up on x-rays, and usually all other options are ruled out by expensive medical tests before RADS is considered. This delays the treatment of symptoms so that the body can begin recovery. The accepted short-term treatment is corticosteroids, which treats symptoms only, by reducing inflammation.
There are implications for local health officials if, as I suspect, others in the county experienced similar ailments. The county’s health department could ask local doctors to report increased complaints of any unusual nature, and officials could review methods of informing the public about air warnings and health measures. Perhaps the dangers of smoke inhalation could be made part of the county’s fire prevention program.
Individuals and caregivers could benefit from a public education program that addresses masks, air filters, keeping doors and windows closed on “bad air” days, and how to keep informed about local air conditions.
For further information, see the following.
Corticosteroids for chronic obstructive pulmonary disease (COPD):
www.questdiagnostics.com/kbase/topic/detail/drug/hw165533/detail.htm
Inhaler Eased Lung Problems in 9/11 Workers/Firefighters who used drug early gained some symptom relief, study found:
Occupational Asthma: A Review:
www.ehponline.org/members/2000/suppl-4/697-704lombardo/lombardo-full.html
Reactive Airways Dysfunction Syndrome (RADS) and irritant induced asthma (IIA):
http://toxicology.leadingexperts.com/rads.html
Reactive airways dysfunction syndrome (RADS). Persistent asthma syndrome after high level irritant exposures:
www.chestjournal.org/content/88/3/376.abstract
Short-term Effects of Wood Smoke Exposure on the Respiratory System Among Charcoal Production Workers:
www.chestjournal.org/content/119/4/1260.abstract
When Asthma and COPD Coexist
www.copd-international.com/Library/asthma-coexist.htm
Janis Paris lives in Spring Valley.
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